Provider Demographics
NPI:1407659840
Name:MOSCHETTI, JUSTINNE TAYLOR (MS)
Entity type:Individual
Prefix:
First Name:JUSTINNE
Middle Name:TAYLOR
Last Name:MOSCHETTI
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16601 N 40TH ST STE 216
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3354
Mailing Address - Country:US
Mailing Address - Phone:520-456-4461
Mailing Address - Fax:
Practice Address - Street 1:16601 N 40TH ST STE 216
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3354
Practice Address - Country:US
Practice Address - Phone:602-767-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor